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Contact Information

ESSENTIAL FAMILY VISION CARE, S.C.
101 S. MAIN ST
DEFOREST, WI53532
 Phone: 608-846-5625
 Fax: 608-846-8998
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for ESSENTIAL FAMILY VISION CARE, S.C.

NPI # 1205953866
LBN Legal business name ESSENTIAL FAMILY VISION CARE, S.C.
Authorized official JULIA EDWARDS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/26/2007
Last updated 04/13/2009 - About 17 years ago
Identifiers
WI License # 2173
WI Medicaid 38723200
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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